Payment Types
We accept: Visa, MasterCard, Discover, CareCredit, Cash and Cashier’s checks. You may pay online through our secure payment portal »

Financial Responsibility
You, the patient, or guardian of the patient, are ultimately responsible for all charges associated with your care, regardless of insurance coverage.

Co-Payment and Deductibles
These are non-negotiable amounts and are a contract responsibility between the patient and their insurance company.

Patients Scheduling Surgery
Within reason, if you fail to keep your appointment or cancel with our business office less than two business days during regular business hours, you will be charged a $350.00 non -refundable failed appointment fee.

Refund Check Replacement Policy
Patients are responsible for ensuring that our office has their current and correct mailing address on file. A $40 administrative fee will be charged for any replacement refund checks requested due to loss, misplacement, expiration, or incorrect address information provided by the patient. This fee covers the processing and reissuance of a new check. To avoid this charge, please verify your address with our office and deposit refund checks promptly upon receipt.

Dental Insurance and Payment Policy
The business office staff will communicate with your insurance company(s) to attempt to verify insurance coverage limits, to help you obtain your maximum benefits, and provide an estimate based on your insurance plan. Our business office will file a claim to be paid directly to us. The balance of the estimated bill will be collected at the time of service.

Medical Insurance
We do not accept most MEDICAL insurance plans. All non-participating medical claims need to be paid in full at the time of service. We are happy ,to bill your medical insurance company when appropriate as a courtesy to you. We will request the payment be made directly to you.

Non-Participating Insurances
If you have insurance that the office does not participate in, our business office will promptly file a claim as a courtesy; however, if payment is not received within 60 days of filing, all charges will become the patient’s responsibility and our office may elect to bill you for the outstanding balance.

Preauthorization
You may request a written pre-authorization of benefits if you are concerned about your financial obligations or the anticipated amount of coverage you may expect from your insurance company is not what was expected. Remember, benefits used between the time of your consultation and the time of surgery may affect available benefit resources. Also, note that the insurance contract you have with your insurance company exists between you and the insurance company. The insurance company is obligated to answer your questions directly. We advise you to keep accurate records of times, dates and names of people you may converse with when speaking with a benefits representative from your insurance.

Insurance Overpayment Refund Policy
Our office will issue a refund 4-8 weeks after our office has received payment from the primary insurance company. Be advised, the insurance companies have a 2-year window of time to ask for a refund according to the State of Washington. If this occurs, it may leave a balance due on your account in which you are responsible.

Treatment of a Minor
If the patient is a minor (under the age of 18), the parent or guardian must sign below. The parent, guardian is responsible for any payment due at the time of service, required referrals and picture ID cards. Minors will not be seen without a parent or legal guardian present.

Additional Charges
For check returned for “Non-Sufficient Funds”, a $35.00 fee will be charged to your account. Personal checks are only accepted 14 business days prior to surgery, we do not take personal checks at the time of service. If you have questions about your insurance, our business office will help you; however, specific coverage issues should be directed to your insurance company member services department.

Past Due Account
Any patient with a past due account may be denied future appointments until the balance is paid in full.